26453Wenzhou Medical University, Wenzhou, China.
89657The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Technol Cancer Res Treat. 2022 Jan-Dec;21:15330338221138208. doi: 10.1177/15330338221138208.
Epidemiologic studies have produced conflicting results on the effects of metformin on pancreatic cancer. This study aimed to observe and analyze whether metformin use is associated with better prognosis in pancreatic cancer. In this retrospective cohort study, all baseline data were retrieved from The Chinese Medicine Information Retrieval System (https://dc.wzhospital.cn/vpn/index.html) of The First Affiliated Hospital of Wenzhou Medical University. Survival data were collected by follow-up visits and medical records. Overall survival was the primary endpoint, while progression-free survival and disease-free survival were secondary endpoints. Progression or recurrence was assessed with radiologic images. Seventy-six metformin users and 92 metformin nonusers diagnosed with pancreatic cancer from 2012 to 2020 in this hospital were enrolled. The adjusted hazard ratio for overall survival for metformin users was 0.50 (95% confidence interval = 0.33-0.76), where median overall survival was 16.0 months for metformin users versus 11.5 months for metformin nonusers. The protective effect was also found by analyzing progression-free survival (adjusted hazard ratio = 0.39, 95% confidence interval = 0.18-0.86) and disease-free survival (adjusted hazard ratio = 0.30, 95% confidence interval = 0.14-0.68). In the subgroup analysis, metformin use had a statistically significant association with prolongation of survival in stage I to II pancreatic cancer patients (hazard ratio = 0.47, 95% confidence interval = 0.25-0.91), but not for advanced tumor stage (hazard ratio for IV stage = 0.62, 95% confidence interval = 0.33-1.19), after adjustment for other risk factors. Metformin use is related to favorable survival outcomes of pancreatic cancer, especially in early tumor stage.
流行病学研究对二甲双胍治疗胰腺癌的效果产生了相互矛盾的结果。本研究旨在观察和分析二甲双胍的使用是否与胰腺癌患者的更好预后相关。
在这项回顾性队列研究中，所有基线数据均从温州医科大学第一附属医院的中医药信息检索系统（https://dc.wzhospital.cn/vpn/index.html）中检索。通过随访和病历收集生存数据。总生存期是主要终点，无进展生存期和无病生存期是次要终点。通过影像学图像评估进展或复发。
从 2012 年至 2020 年，在该院诊断为胰腺癌的 76 名二甲双胍使用者和 92 名二甲双胍非使用者被纳入研究。二甲双胍使用者的总生存期调整后的危险比为 0.50（95%置信区间为 0.33-0.76），其中二甲双胍使用者的中位总生存期为 16.0 个月，而二甲双胍非使用者的中位总生存期为 11.5 个月。在分析无进展生存期（调整后的危险比=0.39，95%置信区间=0.18-0.86）和无病生存期（调整后的危险比=0.30，95%置信区间=0.14-0.68）时，也发现了保护作用。在亚组分析中，在调整了其他危险因素后，二甲双胍的使用与 I 期至 II 期胰腺癌患者的生存延长具有统计学意义（危险比=0.47，95%置信区间=0.25-0.91），但与晚期肿瘤分期无关（IV 期的危险比为 0.62，95%置信区间=0.33-1.19）。
二甲双胍的使用与胰腺癌的良好生存结果相关，尤其是在肿瘤早期阶段。
